Community Health Matching Program: Blue Cross Blue Shield of Michigan Foundation. Solving community health problems. bcbsm.

Transcription

1 Community Health Matching Program: Solving community health problems Blue Cross Blue Shield of Michigan Foundation bcbsm.com/foundation

2 Vision Michigan s population will enjoy improved health and access to costeffective, quality care. The BCBSM Foundation will be a leader in fostering the development of socially responsible and innovative solutions to critical issues that affect the health of all Michigan residents. Mission The Blue Cross Blue Shield of Michigan Foundation s mission is to support health care research and innovative programs designed to improve the health of all Michigan residents. Core Values Commitment to quality performance Honesty, integrity, collaboration and team work Effective and efficient use of resources Excellence in programs, grants and communications The BCBSM Foundation is the philanthropic affiliate of Blue Cross Blue Shield of Michigan (BCBSM) and is a 501(c)(3) nonprofit, incorporated separately from BCBSM. The BCBSM Foundation is an independent licensee of the Blue Cross and Blue Shield Association. BCBSM Foundation grant programs are conducted in Michigan, by Michigan researchers and non-profit community organizations to increase access, address critical public health issues, improve the quality of care, and enhance efficiency. None of the BCBSM Foundation s grant-making resources come from BCBSM customer premium payments. The BCBSM Foundation was funded through an endowment from Michigan physicians in 1983 and from the proceeds of an earlier prescription drug class action lawsuit settlement. For more information about the BCBSM Foundation and its programs, go to bcbsm.com/foundation. 1

3 Overview Since 1980, the Blue Cross Blue Shield of Michigan Foundation has been funding research and community health programs that are making a real difference in the lives of Michigan residents. Through our Community Health Matching Program, we encourage community-based nonprofit organizations to develop, test or validate new approaches that address community health problems. Matching funds are available for programs that help: Increase access to health care Address critical public health issues Improve the quality of care Enhance efficiency Applicants are encouraged to partner with health care organizations, universities, research or governmental agencies to develop projects aimed at addressing community problems. Partners may assist in the design and evaluation of the project. The BCBSM Foundation seeks projects that are: Systemic in nature. Community problems can only be successfully addressed if relevant stakeholders in the community are contributing members of the partnership. Cost-effective. Once operational, the proposed approach will be both affordable and sustainable. Replicable. The proposed approach would be feasible in other communities and would produce similar outcomes; Program focus Increase access to quality health care The Institute of Medicine has reported that a lack of insurance results in over 18,000 unnecessary deaths a year. In comparison with the insured, uninsured adults have a 25 percent greater risk of death. Research indicates that those without access to health care have a disproportionately higher number of health problems in comparison to the insured. Although all Michiganders without access to health care are susceptible to adverse health outcomes, children are particularly vulnerable. Many Michigan children are eligible for MIChild and Healthy Kids but not enrolled. Our most recent data shows that close to 16 percent of nonelderly adults and over 5 percent of Michigan children are uninsured. The BCBSM Foundation s goal is to help bridge that gap by supporting community programs designed to provide quality and affordable health care to Michigan residents who lack adequate health insurance. Without access to care, many people are unable to reach their full potential, which negatively impacts the community as a whole. A strong safety net is needed to provide care. Our current safety net, comprised of a statewide network of hospitals, community health centers, local clinics and primary care physicians, is inadequate to address current needs. Moreover, the capacity of specific components of the safety net and their sources of financial support vary widely. To increase health care access, we are looking for projects that: Provide access to medical, behavioral or dental care to the uninsured and underinsured and/or Increase the capacity of medical, behavioral or dental providers to provide necessary care 2 3

4 Address critical public health issues Public health includes all efforts to protect and improve health conditions affecting the community as a whole, such as childhood obesity, drug abuse, smoking, teen pregnancy and AIDS. Efforts to improve the health of the community may include initiatives aimed at addressing the social determinants of health. Social determinants are the forces that affect both the population and the individual. For example, air quality impacts the health of the community, whereas an individual s genetic makeup and behavior impacts the health of the individual. To address critical public health issues, we are looking for projects that: Address documented community need Are supported by theory or past efforts to address health Include a discussion on the role of the social determinant(s) of health, if appropriate. Improve quality Within the community s health care system, patient safety and quality of care are top concerns. According to the Agency for Healthcare Research and Quality, Quality problems are reflected in the wide variation in the use of health care services, underuse of some services, overuse of other services, and misuse of some services, including an unacceptable level of medical errors. A central goal of health care quality improvement is to maintain what is good about the existing health care system while focusing on the areas that need improvement. The community health care system includes multiple settings, such as physician offices, home health care agencies, community health centers, behavioral health centers, etc. The quality of care provided in these settings might be affected by communication errors, medication safety, iatrogenic infections and providers not following safety and quality guidelines. Disparity of care is also a quality issue. Research shows that ethnic and racial minorities are less likely to receive the quality of care provided to nonminority groups. Cultural and language differences between providers of care and patients, as well as socioeconomic status and education, also can lead to health care disparities. To improve the quality of health care provided in the community, we are looking for projects that: Determine and validate quality care Implement and evaluate processes of care intended to produce quality outcomes Address disparity of care. Enhance efficiency According to the Institute of Medicine, efficiency is one of six necessary attributes for a high-performing health care system. Efficiency is often described as the relationship between cost and outcome achieving the best possible outcome for the lowest possible cost. In health care, efficiency enhances health care value, that is, appropriate health care delivered in a cost-effective and efficient manner. But measuring health care value can be challenging. In a recent article in the New England Journal of Medicine, Michael Porter, Ph.D. states that health care value should be measured by outcomes, not the number of services delivered. Porter defines health care value, which encompasses efficiency, as health outcomes achieved per dollar spent. If health care value improves, all stakeholders including patients, payers and providers can benefit. To enhance efficient health care and create health care value, we are looking for projects that: Implement and evaluate efficient health care processes Validate measurements of value and efficiency. 4 5

5 Grant evaluation criteria Submissions will be evaluated according to the following criteria: Project significance Will the proposed project significantly affect community health and/or health care? Have applicants effectively documented the magnitude of the problem and the anticipated impact of the project on the problem? Proposal quality Is the proposal presented with clarity? Is it well-organized? Does the applicant demonstrate a compelling need for the proposed project, including the rationale for the program/intervention? Project evaluation Has the intervention been tested or previously evaluated? Is the project based on an original idea? Is the proposed project based on a proven model? If so, is there evidence that the model is effective? Is there a description of the evaluation methodology to be employed as well as the suitability of the proposed analytical methods? Future impact Is there a reasonable sustainability plan for the proposed project? If proven effective, can the project/intervention be replicated in other Michigan communities? Are the experience, qualifications and time commitment of the project director and the key project staff appropriate to conduct the proposed project? Project feasibility Does the applicant nonprofit organization have the history, staff and financial stability to conduct the project? Is the budget reasonable, appropriate and feasible to achieve project objectives within the specified time frame and budget? Are there plans to partner with other organizations? Program Funds The BCBSM Foundation dedicates $500,000 per year to our Community Health Matching Program. Grants of $25,000 per year, for a maximum of two years, per project are available from the BCBSM Foundation to increase access, address critical public health issues, improve the quality of care or enhance efficiency. The Community Health Matching Program requires matching funds based on the size of the applicant organization s budget as well as the percent of Medicaid and uninsured patients served. Specific requirements can be seen in the table below. BCBSM Foundation matching grants are contingent on confirmation that the grantee has obtained a commitment of new funds sufficient to support the program. In-kind contributions are not accepted as a match. Applicant organizations do not need a firm commitment of matching support prior to the submission of a proposal (letters from potential funding partners are encouraged, indicating their support for the project and interest in possible funding partnership(s)). Grants under this program do not pay for the costs of equipment (e.g., personal computers), hardware or software. Eligibility This program is intended to provide support to community nonprofit organizations. Nonprofit 501(c)(3) organizations based in Michigan are eligible to apply for funding. The BCBSM Foundation does not provide support to for-profit organizations or individuals associated with organizations not located in Michigan or not serving Michigan residents. Matching Program Match Requirement Organization Budget % of Medicaid and /or uninsured patients served < $ 10 million > $ 10 million < 30% 25% 60% > 30% 10% 25% 6 7

6 Proposal development The applicant should develop a proposal up to 10 double-spaced pages that describes the nature and scope of the problem, a description of the project/ intervention, and a discussion of the evaluation. The evaluation of the proposed project must be rigorous and follow accepted methodology for demonstration projects. We are looking for a thorough evaluation of the effectiveness or outcomes of the project, as well as an assessment of the project s cost-effectiveness. We recommend that external evaluators are involved in the assessment or consult on the evaluation, if necessary. Specifically, we are looking for a project evaluation that includes: The significance of the proposed intervention to increase access to care, address critical public health issues, improve quality, or to enhance efficiency, as well as its anticipated impact Background information regarding the issue(s) being addressed, as well as a description of how it has been addressed previously The primary outcome(s) to be assessed in the evaluation A thorough description of the intervention and its implementation A list of the variables to be used in the evaluation and the data needed to evaluate outcomes A description of the evaluation methodology used to collect, validate and analyze data An assessment of barriers that may impede widespread implementation of the intervention and how the barriers might be overcome Application Instructions Requests for funding should include: Cover letter, including name and phone number of contact person Completed application form, which can be found on our website: bcbsm.com/foundation. Link to Grant Programs and then Community Health Matching Program. Signed Terms and Conditions (found on our website: bcbsm.com/foundation). Link to Grant Programs and then Community Health Matching Program. Three copies of proposal narrative List of proposed funders for matching funds Detailed budget (for the program and evaluation), including justification for each line item Resume of the project director and other key personnel Copy of the most recent Internal Revenue Service 501(c)(3) federal tax exemption letter Questions regarding this program may be sent to foundation@bcbsm.com. Completed applications should be mailed to: Community Health Matching Program BCBSM Foundation MC X E. Lafayette Blvd. Detroit, Michigan For more information about the BCBSM Foundation, visit our website at bcbsm.com/foundation. 8 9

7 bcbsm.com/foundation MC X E. Lafayette Blvd. Detroit, MI R Blue Cross Blue Shield of Michigan and BCBSM Foundation are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.